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Medecins Sans Frontieres nurse says patients were burned in their beds, on an operating table

Attacks continued even after U.S. and Afghan military officials were notified the hospital was being attacked, MSF says

(CNN)Aerial bombardments blew apart a Doctors Without Borders hospital in the battleground Afghan city of Kunduz about the time of a U.S. airstrike early Saturday, killing at least 19 people, officials said.

The blasts left part of the hospital in flames and rubble, killing 12 staffers and seven patients -- including three children -- and injuring 37 other people, the charity said.

As the United States said it was investigating what struck the hospital during the night, the charity expressed shock and demanded answers, stressing that all combatants had been told long ago where the hospital was.

"(The bombing) constitutes a grave violation of international humanitarian law," Doctors Without Borders, known internationally as Medecins Sans Frontieres, or MSF, said.

Photos:Doctors Without Borders hospital attacked in Afghanistan

Flames are visible inside a Doctors Without Borders hospital in Kunduz, Afghanistan, after a U.S. airstrike on Saturday, October 3. At least 30 people died in the attack, the charity said in its internal review of the strike released Thursday, November 5. The commander of U.S. forces in Afghanistan has said the hospital was hit accidentally.

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Photos:Doctors Without Borders hospital attacked in Afghanistan

Doctors Without Borders said it had emailed the GPS coordinates of its main hospital and administration office building at the Kunduz center before the airstrike. The U.S. commander said airstrikes were called after Afghan troops advised they were "taking fire from enemy positions."

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Photos:Doctors Without Borders hospital attacked in Afghanistan

Doctors Without Borders is asking for an indepedent investigation by the International Humanitarian Fact-Finding Commission. President Barack Obama has apologized to the charity group for the attack.

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Photos:Doctors Without Borders hospital attacked in Afghanistan

The attacks came as fighting intensified between Afghan government forces -- supported by U.S. air power and military advisers -- and the Taliban, which invaded Kunduz in late September.

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Photos:Doctors Without Borders hospital attacked in Afghanistan

"We were running a hospital treating patients, including wounded combatants from both sides -- this was not a 'Taliban base,' " said Dr. Joanne Liu, international president of Doctors Without Borders or Médecins Sans Frontières, upon release of the group's internal review of the attack.

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"There are many patients and staff who remain unaccounted for. The numbers may grow as a clearer picture develops of the aftermath of this horrific bombing," MSF said, adding all the dead and injured were Afghans.

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The bombardments continued even after U.S. and Afghan military officials were notified the hospital was being attacked, the charity said.

The circumstances weren't immediately clear, but the U.S. military was conducting an airstrike in Kunduz at the time the hospital was hit, U.S. Army Col. Brian Tibus said.

The military is investigating whether a U.S. AC-130 gunship -- which was in the area firing on Taliban positions to defend U.S. special operations troops there -- is responsible, a U.S. military official said on condition of anonymity.

The White House released a statement from President Barack Obama offering condolences to the charity from the American people.

"The Department of Defense has launched a full investigation, and we will await the results of that inquiry before making a definitive judgment as to the circumstances of this tragedy," the President said. "I ... expect a full accounting of the facts and circumstances."

The top U.S. and NATO military commander in Afghanistan said he spoke to Afghan President Ashraf Ghani about the deadly airstrike, the U.S. military said.

"While we work to thoroughly examine the incident and determine what happened, my thoughts and prayers are with those affected. We continue to advise and assist our Afghan partners as they clear the city of Kunduz and surrounding areas of insurgents. As always, we will take all reasonable steps to protect civilians from harm," said Gen. John F. Campbell.

The incident occurred on roughly the sixth day of fighting between Afghan government forces -- supported by U.S. air power and military advisers -- and the Taliban, which invaded the city early this week.

According to MSF, the compound is gated and no staff members saw any fighters there or nearby.

"If there was a major military operation going on there, our staff would have noticed. And that wasn't the case when the strikes occurred," Christopher Stokes, the charity's general director, told CNN.

One nurse said in an article on the MSF website that he was sleeping in a safe room when he was awakened by a large explosion. The bombing lasted about an hour, Lajos Zoltan Jecs said.

As he went to help the wounded, he and others tried to save a doctor. He died on an office table, Jecs said. The nurse saw six patients who had burned to death in their beds. Another patient was dead on an operating table.

The U.S. special operations troops were in the area advising Afghan forces, the military official who was speaking anonymously said. The official stressed that the information about the probe was preliminary.

Pribus said a "manned, fixed-wing aircraft" conducted a strike "against individuals threatening the force" at 2:15 a.m. local time, and that the strike "may have resulted in collateral damage to a nearby medical facility."

The AC-130 is a large, fixed-wing gunship built on a C-130 Hercules cargo plane airframe, according to Boeing, the manufacturer. The AC-130U, the most advanced model, is armed with a 25-mm Gatling gun, a 40-mm cannon and a 105-mm cannon, according to the Boeing website.

Mourning and condemnation

The U.N. mission in Afghanistan sharply condemned the airstrike.

"I condemn in the strongest terms the tragic and devastating air strike on the Médecins sans Frontières hospital in Kunduz early this morning, which resulted in the deaths and injury of medical personnel, patients and other civilians," said Nicholas Haysom, head of the United Nations Assistance Mission in Afghanistan.

The U.S. Embassy in Kabul expressed condolences on its Facebook page.

"The U.S. Embassy mourns for the individuals and families affected by the tragic incident at the Doctors Without Borders hospital, and for all those suffering from the violence in Kunduz," it read. The embassy praised the group's work as "heroic."

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The International Committee of the Red Cross also expressed condemnation.

"Such attacks against health workers and facilities undermine the capacity of humanitarian organizations to assist the Afghan people at a time when they most urgently need it," said Jean-Nicolas Marti, Head of the ICRC delegation in Afghanistan.